Kornélia Lazányi
4 Summary and recommendations
As it has been demonstrated in this paper, the organisational safety of healthcare organisations is far from optimal. What is more, healthcare is an industry, where the classical approach of standardisation cannot really be applied, since in healthcare to avoid potential harm to patients is more important than compliance with systems and protocols. Hence most processes involve human deliberation and resolution. A safe organisation is therefore established on the attitudes and values of the members of the organisation.
Employees in healthcare institutions, however, are overloaded. The excessive workload, and working in shifts, in addition to the constant responsibility for others’ life may induce various physical and psychic disorders, burnout and fatigue3. Hence staff is often tired to think about organisational safety issues.
Consequently, in order to create a safer organisation, employees and their circumstances have to be addressed.
While the change in physical structures and basic institutional characteristics, such as number and qualifications of or the organisation of care is most often a question of money, motivation, attitudes and behaviour of staff and the employees’ attitude towards safety might be altered by a switch of organisational culture to that of safety culture.
3 In addition they tend to earn less money then the workers with the same level of qualification and responsibility in manufacturing (furthermore the type of responsibility cannot be compared). In Hungary there is a trend that while more and more jobs are created in sectors with better payed industrial working positions (Bereczk, 2014), the rate of real wages in public service remains relatively constant over time.
Organisations with a positive safety culture are able to develop a sensitivity to operational hazards; to identify problems early, so that actions can be taken before they threaten safety. Such organisations are characterised by shared perceptions of the importance of safety and by confidence in the efficacy of preventive measures.
In a safety culture, the role of the management is of high importance in implying that safety needs to be taken seriously at every level of the organisation. Managers need to prove that they are dedicated in creating and operating an organisation that gives the safety of patients and staff a priority. Clarity of purpose is also needed when developing safety measures and procedures.
Every organisation will, if they look, discover numerous incidents and deviations from practices deemed to be safe. Hence safety monitoring is critical and should also be regarded as such. Although healthcare organisations use a wide variety of formal and informal methods to understand how individuals and processes are connected to sagety hazards or the prevention thereof. However, it is important to keep in mind that staff needs time, freedom and authority to not only just monitor but intervene when necessary.
Improved working conditions, health and safety measures taken have significantly contributed to the growth and life expectancy of population for many centuries (Szigeti-Tóth 2013, 2014; Borzán 2004, 2014). Nevertheless, safe organisations do not only try to stick to the best practices of the industry, but actively seek out safety incidents, and respond by attempting to harness the learning to influence their future functioning (Vincent, 2010). Hence, anticipation - thinking ahead and envisioning possible problems and hazards - is a key element of organisational safety. In line with this, safety culture is a system, where questioning is encouraged and those willing and eager to be involved in making plans preparing for safety incidents are empowered.
To sum it up, healthcare organisations are in a tricky situation, when it comes to organisational safety, since the awareness and wilingness of the already overloaded staff would be a key elemet of safety culture. Managers, by creating clear measures and procedures and by setting personal example are able to foster an increased awareness, however structural changes are inevitable for addressing the issue of organisational safety in its entirety.
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